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  1. Article ; Online: Understanding Takotsubo syndrome: first evaluate your mouse model.

    Horowitz, John D / Surikow, Sven Y

    American journal of physiology. Heart and circulatory physiology

    2023  Volume 324, Issue 5, Page(s) H630–H632

    MeSH term(s) Mice ; Animals ; Takotsubo Cardiomyopathy/diagnostic imaging ; Disease Models, Animal ; Reproducibility of Results ; Isoproterenol
    Chemical Substances Isoproterenol (L628TT009W)
    Language English
    Publishing date 2023-03-10
    Publishing country United States
    Document type Research Support, Non-U.S. Gov't ; Editorial ; Comment
    ZDB-ID 603838-4
    ISSN 1522-1539 ; 0363-6135
    ISSN (online) 1522-1539
    ISSN 0363-6135
    DOI 10.1152/ajpheart.00051.2023
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    Uc I Zs.89: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Risk factors for a broken heart: understanding drug-induced causes for Takotsubo syndrome and pharmacological treatment options.

    Ong, Gao Jing / Nguyen, Thanh Ha / Surikow, Sven Y / Horowitz, John D

    Expert review of clinical pharmacology

    2022  Volume 15, Issue 9, Page(s) 1017–1025

    Abstract: Introduction: Takotsubo syndrome (TTS) is an acute inflammatory disorder involving first the vasculature and then the myocardium. It occurs relatively frequently, especially in aging women after acute physical and emotional stress. There is also ... ...

    Abstract Introduction: Takotsubo syndrome (TTS) is an acute inflammatory disorder involving first the vasculature and then the myocardium. It occurs relatively frequently, especially in aging women after acute physical and emotional stress. There is also increasing recognition that TTS attacks are sometimes precipitated by pharmacotherapy.
    Areas covered: The pathogenesis of TTS is described, including components of a complex biochemical 'cascade' centering on aberrant post-receptor signaling following β
    Expert opinion: The biochemical 'cascade' in TTS revolves around an aberrant post-receptor response to β
    MeSH term(s) Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Female ; Humans ; Nitric Oxide ; Poly(ADP-ribose) Polymerase Inhibitors ; Poly(ADP-ribose) Polymerases ; Receptors, Adrenergic ; Risk Factors ; Takotsubo Cardiomyopathy/chemically induced ; Takotsubo Cardiomyopathy/drug therapy
    Chemical Substances Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Poly(ADP-ribose) Polymerase Inhibitors ; Receptors, Adrenergic ; Nitric Oxide (31C4KY9ESH) ; Poly(ADP-ribose) Polymerases (EC 2.4.2.30)
    Language English
    Publishing date 2022-09-11
    Publishing country England
    Document type Journal Article
    ISSN 1751-2441
    ISSN (online) 1751-2441
    DOI 10.1080/17512433.2022.2121701
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  3. Article ; Online: Editorial Commentary: Takotsubo syndrome: A key role for inflammation?

    Nguyen, Thanh H / Surikow, Sven Y / Horowitz, John D

    Trends in cardiovascular medicine

    2020  Volume 31, Issue 4, Page(s) 231–232

    MeSH term(s) Humans ; Inflammation/diagnosis ; Takotsubo Cardiomyopathy/diagnosis
    Language English
    Publishing date 2020-04-25
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 1097434-9
    ISSN 1873-2615 ; 1050-1738
    ISSN (online) 1873-2615
    ISSN 1050-1738
    DOI 10.1016/j.tcm.2020.04.002
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3419: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Incremental "Therapeutic" Myocardial Exposure to Catecholamines: Incidence and Impact in Takotsubo Syndrome.

    Ong, Gao Jing / Nguyen, Thanh Ha / Stansborough, Jeanette / Surikow, Sven Y / Horowitz, John D

    Cardiovascular drugs and therapy

    2020  Volume 34, Issue 1, Page(s) 95–100

    Abstract: Background: Although Takotsubo syndrome (TS) was once considered to be rare and largely benign, it is now recognized to represent a major cause of cardiac morbidity and mortality, especially in ageing women. The biochemical precipitant of attacks of TS ... ...

    Abstract Background: Although Takotsubo syndrome (TS) was once considered to be rare and largely benign, it is now recognized to represent a major cause of cardiac morbidity and mortality, especially in ageing women. The biochemical precipitant of attacks of TS is an increase in catecholamine concentrations within the myocardium, engendering inflammatory activation via biased post-receptor signalling at myocardial β
    Methods/results: Patients' data from a regional registry of 301 consecutive cases of TS were evaluated after exclusion of patients (n = 20) in whom TS had occurred in association with life threatening extracardiac disease states. A total of 55 (18%) of patients were identified as having antecedent exposure to potentially "iatrogenic" agents (tricyclic antidepressants in 24 cases, β
    Conclusion: Potentially iatrogenic precipitation of TS attacks (via iatrogenic elevation of catecholamine levels and β
    MeSH term(s) Adrenergic beta-2 Receptor Agonists/adverse effects ; Aged ; Aged, 80 and over ; Antidepressive Agents, Tricyclic/adverse effects ; Biomarkers/blood ; Female ; Humans ; Iatrogenic Disease ; Incidence ; Male ; Middle Aged ; Myocardium/metabolism ; Normetanephrine/blood ; Prognosis ; Risk Factors ; Takotsubo Cardiomyopathy/blood ; Takotsubo Cardiomyopathy/chemically induced ; Takotsubo Cardiomyopathy/mortality ; Takotsubo Cardiomyopathy/physiopathology ; Time Factors ; Ventricular Function, Left/drug effects
    Chemical Substances Adrenergic beta-2 Receptor Agonists ; Antidepressive Agents, Tricyclic ; Biomarkers ; Normetanephrine (0J45DE6B88)
    Language English
    Publishing date 2020-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639068-7
    ISSN 1573-7241 ; 0920-3206
    ISSN (online) 1573-7241
    ISSN 0920-3206
    DOI 10.1007/s10557-019-06918-5
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    Zs.B 3057: Show issues Location:
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  5. Article ; Online: Takotsubo Syndrome: Finally Emerging From the Shadows?

    Ong, Gao Jing / Nguyen, Thanh Ha / Kucia, Angela / Liu, Sai-Fei / Surikow, Sven Y / Girolamo, Olivia / Chong, Cher-Rin / Chirkov, Yuliy Y / Schenck-Gustafsson, Karin / Frenneaux, Michael P / Horowitz, John D

    Heart, lung & circulation

    2020  Volume 30, Issue 1, Page(s) 36–44

    Abstract: It is now 30 years since Japanese investigators first described Takotsubo Syndrome (TTS) as a disorder occurring mainly in ageing women, ascribing it to the impact of multivessel coronary artery spasm. During the intervening period, it has become clear ... ...

    Abstract It is now 30 years since Japanese investigators first described Takotsubo Syndrome (TTS) as a disorder occurring mainly in ageing women, ascribing it to the impact of multivessel coronary artery spasm. During the intervening period, it has become clear that TTS involves relatively transient vascular injury, followed by prolonged myocardial inflammatory and eventually fibrotic changes. Hence symptomatic recovery is generally slow, currently an under-recognised issue. It appears that TTS is induced by aberrant post-β
    MeSH term(s) Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Magnetic Resonance Imaging, Cine/methods ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/physiopathology ; Ventricular Function, Left/physiology
    Keywords covid19
    Language English
    Publishing date 2020-11-06
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2020.10.006
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4988: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: Takotsubo Syndrome: Finally Emerging From the Shadows?

    Ong, Gao Jing / Nguyen, Thanh Ha / Kucia, Angela / Liu, Sai-Fei / Surikow, Sven Y / Girolamo, Olivia / Chong, Cher-Rin / Chirkov, Yuliy Y / Schenck-Gustafsson, Karin / Frenneaux, Michael P / Horowitz, John D

    Heart lung circ

    Abstract: It is now 30 years since Japanese investigators first described Takotsubo Syndrome (TTS) as a disorder occurring mainly in ageing women, ascribing it to the impact of multivessel coronary artery spasm. During the intervening period, it has become clear ... ...

    Abstract It is now 30 years since Japanese investigators first described Takotsubo Syndrome (TTS) as a disorder occurring mainly in ageing women, ascribing it to the impact of multivessel coronary artery spasm. During the intervening period, it has become clear that TTS involves relatively transient vascular injury, followed by prolonged myocardial inflammatory and eventually fibrotic changes. Hence symptomatic recovery is generally slow, currently an under-recognised issue. It appears that TTS is induced by aberrant post-ß2-adrenoceptor signalling in the setting of "surge" release of catecholamines. Resultant activation of nitric oxide synthases and increased inflammatory vascular permeation lead to prolonged myocardial infiltration with macrophages and associated oedema formation. Initially, the diagnosis of TTS was made via exclusion of relevant coronary artery stenoses, plus the presence of regional left ventricular hypokinesis. However, detection of extensive myocardial oedema on cardiac MRI imaging offers a specific basis for diagnosis. No adequate methods are yet available for definitive diagnosis of TTS at hospital presentation. Other major challenges remaining in this area include understanding of the recently demonstrated association between TTS and antecedent cancer, the development of effective treatments to reduce risk of short-term (generally due to shock) and long-term mortality, and also to accelerate symptomatic recovery.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #912219
    Database COVID19

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  7. Article ; Online: Assessment of Artificial Intelligence in Echocardiography Diagnostics in Differentiating Takotsubo Syndrome From Myocardial Infarction.

    Laumer, Fabian / Di Vece, Davide / Cammann, Victoria L / Würdinger, Michael / Petkova, Vanya / Schönberger, Maximilian / Schönberger, Alexander / Mercier, Julien C / Niederseer, David / Seifert, Burkhardt / Schwyzer, Moritz / Burkholz, Rebekka / Corinzia, Luca / Becker, Anton S / Scherff, Frank / Brouwers, Sofie / Pazhenkottil, Aju P / Dougoud, Svetlana / Messerli, Michael /
    Tanner, Felix C / Fischer, Thomas / Delgado, Victoria / Schulze, P Christian / Hauck, Christian / Maier, Lars S / Nguyen, Ha / Surikow, Sven Y / Horowitz, John / Liu, Kan / Citro, Rodolfo / Bax, Jeroen / Ruschitzka, Frank / Ghadri, Jelena-Rima / Buhmann, Joachim M / Templin, Christian

    JAMA cardiology

    2022  Volume 7, Issue 5, Page(s) 494–503

    Abstract: Importance: Machine learning algorithms enable the automatic classification of cardiovascular diseases based on raw cardiac ultrasound imaging data. However, the utility of machine learning in distinguishing between takotsubo syndrome (TTS) and acute ... ...

    Abstract Importance: Machine learning algorithms enable the automatic classification of cardiovascular diseases based on raw cardiac ultrasound imaging data. However, the utility of machine learning in distinguishing between takotsubo syndrome (TTS) and acute myocardial infarction (AMI) has not been studied.
    Objectives: To assess the utility of machine learning systems for automatic discrimination of TTS and AMI.
    Design, settings, and participants: This cohort study included clinical data and transthoracic echocardiogram results of patients with AMI from the Zurich Acute Coronary Syndrome Registry and patients with TTS obtained from 7 cardiovascular centers in the International Takotsubo Registry. Data from the validation cohort were obtained from April 2011 to February 2017. Data from the training cohort were obtained from March 2017 to May 2019. Data were analyzed from September 2019 to June 2021.
    Exposure: Transthoracic echocardiograms of 224 patients with TTS and 224 patients with AMI were analyzed.
    Main outcomes and measures: Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity of the machine learning system evaluated on an independent data set and 4 practicing cardiologists for comparison. Echocardiography videos of 228 patients were used in the development and training of a deep learning model. The performance of the automated echocardiogram video analysis method was evaluated on an independent data set consisting of 220 patients. Data were matched according to age, sex, and ST-segment elevation/non-ST-segment elevation (1 patient with AMI for each patient with TTS). Predictions were compared with echocardiographic-based interpretations from 4 practicing cardiologists in terms of sensitivity, specificity, and AUC calculated from confidence scores concerning their binary diagnosis.
    Results: In this cohort study, apical 2-chamber and 4-chamber echocardiographic views of 110 patients with TTS (mean [SD] age, 68.4 [12.1] years; 103 [90.4%] were female) and 110 patients with AMI (mean [SD] age, 69.1 [12.2] years; 103 [90.4%] were female) from an independent data set were evaluated. This approach achieved a mean (SD) AUC of 0.79 (0.01) with an overall accuracy of 74.8 (0.7%). In comparison, cardiologists achieved a mean (SD) AUC of 0.71 (0.03) and accuracy of 64.4 (3.5%) on the same data set. In a subanalysis based on 61 patients with apical TTS and 56 patients with AMI due to occlusion of the left anterior descending coronary artery, the model achieved a mean (SD) AUC score of 0.84 (0.01) and an accuracy of 78.6 (1.6%), outperforming the 4 practicing cardiologists (mean [SD] AUC, 0.72 [0.02]) and accuracy of 66.9 (2.8%).
    Conclusions and relevance: In this cohort study, a real-time system for fully automated interpretation of echocardiogram videos was established and trained to differentiate TTS from AMI. While this system was more accurate than cardiologists in echocardiography-based disease classification, further studies are warranted for clinical application.
    MeSH term(s) Aged ; Artificial Intelligence ; Cohort Studies ; Echocardiography ; Female ; Humans ; Male ; Myocardial Infarction/diagnostic imaging ; Takotsubo Cardiomyopathy/diagnostic imaging
    Language English
    Publishing date 2022-03-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2380-6591
    ISSN (online) 2380-6591
    DOI 10.1001/jamacardio.2022.0183
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  8. Article ; Online: Nitrosative Stress as a Modulator of Inflammatory Change in a Model of Takotsubo Syndrome.

    Surikow, Sven Y / Nguyen, Thanh H / Stafford, Irene / Chapman, Matthew / Chacko, Sujith / Singh, Kuljit / Licari, Giovanni / Raman, Betty / Kelly, Darren J / Zhang, Yuan / Waddingham, Mark T / Ngo, Doan T / Bate, Alexander P / Chua, Su Jen / Frenneaux, Michael P / Horowitz, John D

    JACC. Basic to translational science

    2018  Volume 3, Issue 2, Page(s) 213–226

    Abstract: Previous studies have shown that patients with Takotsubo syndrome (TS) have supranormal nitric oxide signaling, and post-mortem studies of TS heart samples revealed nitrosative stress. Therefore, we first showed in a female rat model that isoproterenol ... ...

    Abstract Previous studies have shown that patients with Takotsubo syndrome (TS) have supranormal nitric oxide signaling, and post-mortem studies of TS heart samples revealed nitrosative stress. Therefore, we first showed in a female rat model that isoproterenol induces TS-like echocardiographic changes, evidence of nitrosative stress, and consequent activation of the energy-depleting enzyme poly(ADP-ribose) polymerase-1. We subsequently showed that pre-treatment with an inhibitor of poly(ADP-ribose) polymerase-1 ameliorated contractile abnormalities. These findings thus add to previous reports of aberrant β-adrenoceptor signaling (coupled with nitric oxide synthase activation) to elucidate mechanisms of impaired cardiac function in TS and point to potential methods of treatment.
    Language English
    Publishing date 2018-04-18
    Publishing country United States
    Document type Journal Article
    ISSN 2452-302X
    ISSN (online) 2452-302X
    DOI 10.1016/j.jacbts.2017.10.002
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